Examples from US Policies to Reduce Oversupply and Overutilization: Lessons for the Japanese Health Care System

Area of Science:

• Health Economics
• Comparative Health Systems
• Healthcare Policy

Background:

• Japan's universal healthcare system faces fiscal pressures from an aging population and new technologies.
• Government price controls have limited spending growth, but utilization remains a challenge.
• The Japanese system lacks infrastructure for utilization management, unlike the US system.

Purpose of the Study:

• To compare healthcare spending drivers in Japan and the US.
• To identify potential strategies for Japan to manage healthcare utilization and costs.
• To explore how US utilization management tools could benefit the Japanese healthcare system.

Main Methods:

• Comparative analysis of healthcare system structures.
• Review of cost containment and utilization management strategies.
• Examination of demographic and technological impacts on healthcare spending.

Main Results:

• Japan's system struggles with utilization due to limited management infrastructure.
• The US system, despite high costs and coverage gaps, employs tools like prior authorization and gatekeeping to manage utilization.
• Both systems face unique challenges but offer lessons for each other.

Conclusions:

• Japan could benefit from adopting utilization management strategies to control healthcare spending.
• Comparative analysis highlights opportunities for Japan to enhance healthcare value.
• Lessons from the US system may inform Japanese healthcare policy for better cost control.